Disease Management Update
Volume IV, No. 22
September 20, 2007

Dear Healthcare Intelligence Network Client,

Asthma. It affects nearly 30.8 million people in the United States — including 8.9 million children — and it is estimated to affect as many as 300 million people worldwide. This week's Disease Management Update looks at an asthma management technique and factors that go into asthma management education. Visit HIN's blog to read about what you can do to ensure positive outcomes in the asthma management of your patients.

Your colleague in the business of healthcare,
Laura M. Greene
Editor, Disease Management Update

If this is a forwarded copy of Disease Management Update and you like what you see, you can register to receive your own copy of this complimentary service. Sign up at: http://www.hin.com/dmdesktop/diseasemanagement.html

Table of Contents

  1. Physical Fitness Improves Asthma Management in Children
  2. Disease Management Q&A: Targeting Members After Stratification
  3. HealthSounds Podcast: Treating the Whole Patient
  4. Asthma Self-Management Education Differs Among Sex, Age and Race
  5. Integrated Care Yields Better Outcomes For Chronically-Ill and High-Cost Patients


1. Physical Fitness Improves Asthma Management in Children

Children with asthma who improve their physical fitness are likely to experience beneficial effects on disease control and quality of life, according to the American College of Sports Medicine (ACSM). The results of the study show that aerobic training is effective in improving cardiopulmonary fitness and decreasing daily use of inhaled steroids in asthmatic children.

The study consisted of 38 children, all with moderate-to-severe asthma, who were assigned to a training group or a control group. Elements such as exercise performance and exercise-induced bronchoconstriction were evaluated for 16 weeks as researchers recorded their daily doses of inhaled steroids and their Pediatric Asthma Quality of Life Questionnaire (PAQLQ) scores.

The children showed significant improvements in their aerobic capacity and a reduction in exercise induced-bronchoconstriction after the training program. Daily doses of inhaled steroids were reduced in trained patients by 52 percent while remaining unchanged or increased in the control group. Children in the training group experienced a significant improvement in health-related quality of life, compared to those in the control group.

To learn more about the findings of this study, please visit:
http://www.acsm.org/AM/Template.cfm?Section=Home_Page&CONTENTID=8124&TEMPLATE=/CM/ContentDisplay.cfm

2. Disease Management Q&A: Targeting Members After Stratification

Each week, a healthcare professional responds to a reader's query on an industry issue. This week's expert is Mary Bryngelson, regional vice president of Healthways.

Question: When making outbound calls to the stratified population at Blue Cross and Blue Shield of Minnesota, are you calling mild asthmatics as well as moderate and severe cases, or do you target call campaigns to just moderate and severe cases?

Response: (Mary Bryngelson) We calibrate the interventions according to the stratification level. Asthma is a good example. When we do an assessment and determine that an individual is stable and has mild asthma, we place them in our asthma maintenance program. Those individuals receive mailings to keep them current with the literature for their condition, but they are not contacted as frequently as someone who may have gone into the emergency room recently. However, if you are stable and a trigger hits through a claim, we immediately reach out to them to offer the help they need for that particular incident.

To get more detailed solutions to some of the top challenges faced by healthcare executives today, please visit:
http://store.hin.com/product.asp?itemid=3559

We want to hear from you! Submit your question for Disease Management Q&A to info@hin.com.

3. HealthSounds Podcast: Treating the Whole Patient

In this week's Disease Management podcast, Lenore Blank, Michelle Gilbert, Donna Isgett and Leanne Huminski describe how their organizations are implementing perfect care processes in heart failure and medication management with details on how they've implemented their programs and the results they are achieving.

To listen to this complimentary HIN podcast, please visit:
http://www.hin.com/podcasts/podcast.htm#44

4. Asthma Self-Management Education Differs Among Sex, Age and Race

The prevalence of asthma education varies by sex, age group, ethnicity and health insurance status, according to a study in Morbidity and Mortality Weekly Report. The study notes that a significant portion of youths and adults with asthma do not have the education needed to manage their disease effectively and control their asthma symptoms.

Of the 43,101 adults and youths questioned, youths had a significantly higher prevalence of each component of asthma education than did adults overall. For youths, prevalence of asthma education ranged from 40 percent — for having ever had an asthma management plan — to 78 percent — for having ever been taught how to respond to an asthma attack. For adults, prevalence ranged from 12 percent — for having ever taken a class on asthma management — to 65 percent — for having ever been taught how to respond to an asthma attack.

While 12 percent of non-Hispanic white youths reported taking an asthma class and 76 percent reported being taught to respond to an asthma attack, only 23 percent and 80 percent respectively of non-Hispanic blacks youths reported the same. Similarly, 21 percent of other non-Hispanic races or ethnicities reported taking an asthma class, while 92 percent reported being taught to respond to an asthma attack.

Women were more likely than men to have ever had an asthma management plan, to have ever been taught to monitor peak flow, to have been taught how to respond to an asthma attack and to have been advised to modify aspects of home, school or work. Those 65 years or older were less likely to have been taught how to respond to an asthma attack and to have been counseled to modify factors at home, school or work than persons 18 to 34 years of age.

A lower proportion of adults with no health insurance was less likely than adults with private insurance to report that they had ever had an asthma management plan, been taught to monitor peak flow, taken a class on asthma management and been taught how to respond to an asthma attack. Those with private health insurance were also more likely to have been taught to recognize early signs of an asthma attack, to have been taught how to respond to an asthma attack, and to have been counseled to modify factors at home, school, or work than adults on Medicare coverage.

To see more of this survey's results, please visit:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5635a4.htm

5. Integrated Care Yields Better Outcomes For Chronically-Ill and High-Cost Patients

McKesson Corporation and CMS Health Integrated are providing CoverColorado with the nationís first integrated care program for high-risk health plan participants. More than 3,000 people with chronic and high-cost health conditions now have access to an around-the-clock, integrated care program that includes both disease management and case management services.

To download this complimentary white paper, please visit:
http://www.hin.com/library/registericp.html

Please forward this news announcement to your colleagues who might find it useful.
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